147 The influence of type 2 diabetes mellitus on development of diastolic heart failure - 3-year follow-up

2003 ◽  
Vol 2 (1) ◽  
pp. 25
Author(s):  
A MAMCARZ ◽  
M JANISZEWSKI ◽  
J SYSKASUMINSKA ◽  
W BRAKSATOR ◽  
M CHMIELEWSKI ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diastolic Heart Failure

scholarly journals Association between Markers of Fibrosis and Heart Failure Incidence in Patients with Type 2 Diabetes Mellitus

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Denis A. Lebedev ◽  
Elena A. Lyasnikova ◽  
Elena Yu. Vasilyeva ◽  
Nikolai P. Likhonosov ◽  
Maria Yu. Sitnikova ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Type I ◽  
Procollagen Type ◽  
Sodium Glucose Cotransporter ◽  
Increased Risk

Type 2 diabetes mellitus (T2DM) and chronic heart failure (HF) have close association, and several biomarkers have been studied to better understand this association and improve prediction of HF in T2DM. Furthermore, in recent clinical trials, sodium glucose cotransporter 2 inhibitors (SGLT2i), glucose-lowering drugs, improved HF outcomes. The objective of the present study was to evaluate association between circulating biomarkers of fibrosis and incidence of HF with preserved ejection fraction (HFpEF) in patients with T2DM receiving sodium glucose cotransporter 2 inhibitors (SGLT2i). Materials and Methods. At baseline, transthoracic echocardiography and laboratory assessment of N-terminal fragment of the brain natriuretic peptide (Nt-proBNP), soluble suppression of tumorigenesis-2 (sST2), galectin-3 (Gal-3), C-terminal propeptide of procollagen type I (PICP), N-terminal propeptide of procollagen type III (PIIINP), matrix metalloproteinase-9 (MMP-9), and tissue inhibitor of matrix proteinase-1 (TIMP-1) were done. After 3 years of follow-up, information about HF events (hospitalization for HF, established HF in outpatient department by a cardiologist) was obtained. Results. Seventy-two patients were included in the study. The mean age was 57 (49.7; 63.2) years; 44% were female. Most patients had T2DM for more than 4 years. All patients were overweight or had obesity, and 93% patients had arterial hypertension (AH). After 3 years of follow-up, HFpEF was established in 21% patients. Patients were divided into two groups according to the presence of HFpEF, and baseline characteristics were compared. Patients with HF were older and had longer diabetes and AH duration and higher Nt-proBNP, Gal-3, PIIINP, and PICP levels at baseline than patients without HF (all p < 0.05 ). Gal − 3 > 10  ng/ml ( OR = 2.25 ; 95% CI, 1.88–5.66; p = 0.01 ) and NT − pro − BNP > 80  pg/ml ( OR = 2.64 ; 95% CI, 1.56–4.44; p = 0.001 ) were associated with increased risk of HF incidence. Age > 60 years, diabetes duration > 10 years, and presence of abdominal obesity were independent predictors of HFpEF as well. Conclusions. T2DM patients treated with SLGT2i, who developed HFpEF after 3 years of follow-up, had higher PICP, PIIINP, Gal-3, and NT-proBNP serum concentrations at baseline, and Gal-3 level was an independent predictor of HFpEF.

scholarly journals Prognostic Value of Secreted Frizzled-Related Protein 5 in Heart Failure Patients With and Without Type 2 Diabetes Mellitus

2020 ◽  
Vol 13 (9) ◽  
Author(s):  
Jiandi Wu ◽  
Haoxiao Zheng ◽  
Xinyue Liu ◽  
Peisong Chen ◽  
Yunlong Zhang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Heart Failure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Prognostic Value ◽  
Primary Outcome ◽  
Related Protein

Background: Patients with heart failure (HF) with diabetes mellitus have distinct biomarker profiles compared with those without diabetes mellitus. SFRP5 (secreted frizzled-related protein 5) is an anti-inflammatory adipokine with an important suppressing role on the development of type 2 diabetes mellitus (T2DM). This study aimed to evaluate the prognostic value of SFRP5 in patients with HF with and without T2DM. Methods: The study included 833 consecutive patients with HF, 312 (37.5%) of whom had T2DM. Blood samples were collected at presentation, and SFRP5 levels were measured. The primary outcome was the composite end points of first occurrence of HF rehospitalization or all-cause mortality during follow-up. Results: During median follow-up of 2.1 years, 335 (40.2%) patients in the cohort experienced the composite primary outcome. After adjustment for multiple risk factors, each doubling of SFRP5 level was associated with a 21% decreased risk of primary outcomes in the overall study population ( P <0.001). Subgroup analyses showed that the association between level of SFPR5 and primary outcomes may be stronger in patients with T2DM (hazard ratio, 0.69 [95% CI, 0.61–0.79]) than in patients without T2DM (hazard ratio, 0.89 [95% CI, 0.79–1.01]; interaction P =0.006). Similar associations were observed when taking SFRP5 as a categorical variable. Addition of SFRP5 significantly improved discrimination and reclassification of the incident primary outcomes beyond clinical risk factors and N-terminal pro-B-type natriuretic peptide in all patients with HF and those with T2DM (all P <0.01). Conclusions: SFRP5 is an independent novel biomarker for risk stratification in HF, especially in HF with T2DM.

scholarly journals Vasomotor arterial endothelial dysfunction and hyperhomocysteinemia as diastolic heart failure progression risk factors in case of carbohydrate metabolism disorders

2015 ◽  
Vol 96 (6) ◽  
pp. 918-923
Author(s):  
A G Denisova ◽  
I P Tatarchenko ◽  
N V Pozdnyakova ◽  
O I Morozova
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Endothelial Dysfunction ◽  
Carbohydrate Metabolism ◽  
Diastolic Heart Failure ◽  
Control Group ◽  
Homocysteine Concentration

Aim. To evaluate significance of hyperhomocysteinemia and arterial endothelial dysfunction in the progression of diastolic heart failure in case of carbohydrate metabolism disorders. Methods. The study included 134 patients (63 men and 71 women), mean age - 59.3±4.7 years. The first group included patients with ischemic heart disease associated with type 2 diabetes mellitus (n=46). The second group included patients with type 2 diabetes mellitus and hypertension (n=48). The control group (n=40) included healthy volunteers without carbohydrate metabolism disorders and history of cardiovascular diseases. Results. Homocysteine concentration was 19.7±5.2 mmol/l in patients with type 2 diabetes mellitus, and was significantly higher than in the control group - 10.77±3.9 mmol/l (p

scholarly journals 210 Analysis of causes of heart failure in patients with type 2 diabetes mellitus — a 5-year follow-up

2003 ◽  
Vol 4 ◽  
pp. S24
Author(s):  
A MAMCARZ ◽  
W BRAKSATOR ◽  
M JANISZEWSKI ◽  
A SWIATOWIEC ◽  
J SYSKASUMINSKA ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus

scholarly journals The Association Between Metformin Treatment and Outcomes in Type 2 Diabetes Mellitus Patients With Heart Failure With Preserved Ejection Fraction: A Retrospective Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Jianfang Wang ◽  
Yi Lu ◽  
Xinjia Min ◽  
Tan Yuan ◽  
Jia Wei ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Preserved Ejection Fraction ◽  
Metformin Group ◽  
Patients With Heart Failure ◽  
All Cause Mortality

Background: Metformin is the first-line antidiabetic medication for type 2 diabetes mellitus (T2DM). However, the association between metformin and outcomes in T2DM patients with heart failure with preserved ejection fraction (HFpEF) is still unknown. We aimed to explore the association between metformin and adverse outcome in T2DM patients with HFpEF.Methods: A total of 372 T2DM patients with HFpEF hospitalized from January 1, 2013, to December 31, 2017, were included in this retrospective cohort study. There were 113 and 259 subjects in metformin and non-metformin group, respectively. Subjects were followed up for all-cause mortality, cardiovascular death, all-cause hospitalization, and heart failure hospitalization.Results: The median follow-up period was 47 months. Eleven patients (2.49% per patient-year) in the metformin group and 56 patients (5.52% per patient-year) in the non-metformin group deceased during follow-up (P = 0.031). However, a multivariable Cox regression failed to show that metformin was an independent factor of all-cause mortality [HR (95% CI) = 0.682 (0.346–1.345); P = 0.269]. A subgroup analysis revealed a significant association between metformin and all-cause mortality in patients with a higher hemoglobin A1c (HbA1c) level (HbA1c ≥7%) [HR (95% CI) = 0.339 (0.117–0.997); P = 0.045]. The 4-year estimated number needed to treat (NNT) with metformin compared with non-metformin for all-cause mortality was 12 in all populations and 8 in the HbA1c ≥7% subgroup.Conclusions: Metformin was not independently associated with clinical outcomes in patients with T2DM and HFpEF, but was associated with lower all-cause mortality in the subgroup of patients with poor glycemic control. Prospective, randomized controlled trials are needed to further verify these findings.

Abstract 15516: Predicting Heart Failure Hospitalization in Type 2 Diabetes Mellitus: Validation of the TRS-HFDM Score in the ACCORD Trial

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Malik Elharram ◽  
Thao Huynh ◽  
Jiayi Ni ◽  
João P Ferreira ◽  
Abhinav Sharma
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Risk Score ◽  
Kaplan Meier ◽  
Increased Risk ◽  
Event Rates

Background: Patients with type 2 diabetes mellitus (T2DM) are at an increased risk for developing heart failure (HF), and clinical models are needed to identify patients with a greater risk for HF hospitalization (HHF). The Thrombolysis in Myocardial Infarction Risk Score for Heart Failure in Diabetes (TRS-HFDM) was recently developed and validated to predict HHF in patients with T2DM in two large clinical trials (SAVOR-TIMI 53 and DECLARE-TIMI 58). We aimed to validate the TRS-HFDM in another cohort of patients with T2DM. Methods: We validated the TRS-HFDM score in 5,123 patients with T2DM for fatal or non-fatal HHF in the placebo arm of the ACCORD (Action to Control Cardiovascular Risk in Diabetes Study Group). The TRS-HFDM included: prior HF, history of atrial fibrillation, coronary artery disease, estimated glomerular filtration rate, and urine albumin-to-creatinine ratio. We evaluated discrimination with the Harrell C index, and calibration by comparing observed event rates for HHF with predicted risk, and the Nam-D’Agostino statistic. Results: During a mean follow up of 4.8 years, 212 patients (4.14%) experienced at least one HHF. The mean age was 63 ±6.7 years, and 38% were female. The baseline hemoglobin A1C was 8.3%, and 36% were on insulin. The ACCORD patients had less comorbidities with a lower proportion of patients with renal dysfunction (8% vs. 16% vs. 17%), established cardiovascular disease (35% vs.79% vs. 41%) and pre-existing HF (5% vs. 13% vs. 10%) compared to patients enrolled in the SAVOR-TIMI 53 and DECLARE TIMI-58 trials respectively. In our cohort, the TRS-HFDM score predicted well HHF events with a Harrel C index of 0.78. The integer-based score was well calibrated, with the observed Kaplan-Meier HHF rates closely predicting the Kaplan-Meier event rates at the end follow up (Nam D`Agostino test: 65.39 (p<0.0001). Discussion: Our findings confirm the applicability of the TRS-HFDM in a large cohort of patients with T2DM with less high-risk features than the SAVOR-TIMI 53 and DECLARE-TIMI 58 populations. Future validation of this risk score in observational cohort studies is needed to evaluate its external validity in a general clinical setting.

scholarly journals Clinical and echocardiographic management of patients with Chronic Heart Failure and Type 2 Diabetes Mellitus: the SCODIAC Follow up Study

2020 ◽  
Author(s):  
Mariarosaria De Luca ◽  
Giorgio Bosso ◽  
Antonio Valvano ◽  
Vincenzo Guardasole ◽  
Amodio Botta ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Left Ventricular ◽  
Diabetic Patients ◽  
Second Phase ◽  
One Year

Abstract Background SCODIAC study revealed an increasing use of SGLT2 inhibitors in 123 patients affected with Heart Failure (HF) and Type 2 Diabetes Mellitus (T2DM), referred to Cardiologists and Diabetologists of the pertaining healthcare districts. SCODIAC Follow Up, the second phase of the program, has been carried out to determine diagnostic and therapeutic pathways in a larger group of HF diabetic patients and to verify whether the use of innovative antidiabetic therapies could modify echocardiographic parameters and influence cardiological therapy. Methods 406 patients affected with HF and T2DM, referred to Cardiologists and Diabetologists of pertaining healthcare districts in Campania, and followed for at least one year between 2018 and 2019, were enrolled in this retrospective study and divided in Group A, composed of 136 HF diabetic patients with preserved Ejection Fraction (HF-pEF) (> 45%) and Group B, formed of 270 HF diabetic patients with reduced EF (HF-rEF) (≤ 45%). All patients had performed periodic clinical evaluations and an echocardiographic exam every 12 months. Anthropometric parameters, HF etiology, co-morbidities, complications and ongoing therapies were collected. Results The clinical and laboratory parameters and the treatments adopted were assessed at beginning and after 12 months of treatment. The antidiabetic therapies resulted modified after one year with a greater use of GLP1 AR, gliptins and SGLT2i. Cardiological therapy resulted also modified with a greater use of ARNI and a reduction of ACE inhibitors and ARBs in HF-rEF patients. At the end of the study echocardiography E velocity, A velocity and E/E’ ratio resulted markedly reduced in 25 HF-pEF patients and in 60 HF-rEF patients treated with SGLT2i, in respect to both the whole sample of subjects at beginning and the other diabetic patients, while LAVi resulted reduced only in HF-pEF patients and EF increased only in HF-rEF patients. Conclusions The approach to the patients with HF and T2DM must necessarily take place in the healthcare districts and be multidisciplinary and integrated in order to tailor therapy to the characteristics of the patient. SGLT2i could improve left ventricular function in HF-rEF patients and modify cardiological therapeutic approach, almost in this setting of patients. Trial registration: The protocol was approved by the University of Naples Federico II Ethics Committee and registered at ClinicalTrial.gov (CT04375943). The principles outlined in the Declaration of Helsinki were followed.

scholarly journals A study on diastolic dysfunction in asymptomatic type 2 diabetes mellitus with normal systolic function

2019 ◽  
Vol 6 (3) ◽  
pp. 890
Author(s):  
M. Ilamaran ◽  
A. Thangadhurai ◽  
P. Suresh Kumar ◽  
Saranya Nagalingam
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diastolic Dysfunction ◽  
Diastolic Heart Failure ◽  
Chi Square ◽  
High Incidence ◽  
Chi Square Test

Background: Diastolic heart failure, otherwise called as heart failure with preserved ejection fraction, is common finding of hypertensive heart disease, but various studies report a high incidence of diastolic heart failure in patients with type 2 diabetes mellitus in spite of the absence of coronary artery heart disease and hypertension. The objectives of the study were to determine the prevalence of dysfunction of left ventricle in diastole in type 2 diabetes mellitus patients and to compare with the non-diabetic individuals with that of asymptomatic type II diabetes patients. To assess the correlation of diastolic dysfunction in diabetes with age of patients, HbA1c levels, duration of diabetes, retinopathy, autonomic neuropathy.Methods: A prospective cross sectional among them 50 patients were diabetics and 50 were non-diabetic controls. Diastolic dysfunction was measured with standard echocardiographic parameters and the results were computed with corresponding variables of the patients. All the variables and their data were analysed for percentage, mean, standard deviation ‘t’ test and chi square test. The ‘t’-test was used to study the quantitative data while chi square test was used to study the qualitative data.Results: Among the study population 60% had diastolic dysfunction and 14% had diastolic dysfunction among cases and control group respectively. Diastolic dysfunction was present among 23.3% and the 76.7% of the age group groups of less than 45 and more than 45 years of age respectively. In this study poor glycaemic status was significantly associated with diastolic dysfunction, whereas duration of diabetes, retinopathy and autonomic neuropathy were not statistically significant.Conclusions: Present study reveals moderately high incidence of diastolic dysfunction in asymptomatic diabetic; subjects and, this finding was correlated with the HBA1C levels but not with retinopathy and autonomic neuropathy.

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